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Titolo:
ORAL ANGIOTENSIN-CONVERTING-ENZYME INHIBITORS
Autore:
VERMEGIBBONEY C;
Indirizzi:
UNIV ILLINOIS,HEALTHSYST CONSORTIUM,2001 SPRING RD,SUITE 700 OAK BROOK IL 60523 SMITHKLINE BEECHAM PHARMACEUT PHILADELPHIA PA 00000 UNIV CINCINNATI HOSP CINCINNATI OH 00000
Titolo Testata:
American journal of health-system pharmacy
fascicolo: 23, volume: 54, anno: 1997,
pagine: 2689 - 2703
SICI:
1079-2082(1997)54:23<2689:OAI>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONGESTIVE-HEART-FAILURE; LEFT-VENTRICULAR DYSFUNCTION; ACUTE MYOCARDIAL-INFARCTION; CORONARY-ARTERY DISEASE; ACE-INHIBITORS; THERAPEUTIC EFFICACY; INSULIN-RESISTANCE; DIABETIC NEPHROPATHY; DRUG-INTERACTIONS; CLINICAL-TRIALS;
Keywords:
ANGIOTENSIN-CONVERTING-ENZYME INHIBITORS; COSTS; DOSAGE; DOSAGE SCHEDULES; DRUG INTERACTIONS; DRUGS; FORMULARIES; MECHANISM OF ACTION; METABOLISM; PHARMACOKINETICS; PHARMACY, INSTITUTIONAL, HOSPITAL; SUBSTITUTION; TOXICITY;
Tipo documento:
Review
Natura:
Periodico
Citazioni:
83
Recensione:
Indirizzi per estratti:
Citazione:
C. Vermegibboney, "ORAL ANGIOTENSIN-CONVERTING-ENZYME INHIBITORS", American journal of health-system pharmacy, 54(23), 1997, pp. 2689-2703

Abstract

The pharmacology, pharmacokinetics, clinical uses, adverse effects, drug interactions, dosage, cost, and therapeutic interchange of oral angiotensin-converting-enzyme (ACE) inhibitors are reviewed. ACE inhibitors attenuate the formation of angiotensin II and may lead to the accumulation of kinins. Although the hypotensive effects of many ACE inhibitors may persist for 24 hours, some patients require more than one dose per day to achieve adequate control. These agents accumulate in patients with renal or hepatic dysfunction, but it is unclear whether dosage adjustments are necessary. ACE inhibitors are effective against mild to moderate hypertension; for severe hypertension, additional antihypertensive agents may be necessary. Other conditions in which ACE inhibitors have shown efficacy include congestive heart failure, myocardial infarction, left ventricular dysfunction, left ventricular hypertrophy, chronic renal insufficiency, insulin sensitivity, and coronary artery disease. The most common adverse effect is a persistent nonproductive cough. Angioedema, fetal and neonatal morbidity and mortality, acute renal failure, and hyperkalemia may also occur. ACE inhibitors mayinteract with diuretics, lithium, nonsteroidal anti-inflammatory drugs, oral hypoglycemic agents, and some other drugs. ACE inhibitor therapy should be initiated with low doses that may then be slowly adjustedupward. Many of the agents have similar costs for lower and higher dosages. The only significant differences among the ACE inhibitors are the time to onset of hypotensive effects, time to peak effect, and duration of effect. Each formulary should include, at least, captopril andone intermediate-acting and one long-acting ACE inhibitor.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 11:24:18